Multiple primary cancers with gastrointestinal malignant tumors as the first manifestation: Three case reports and review of literature

Table 1 Summary of cases with multiple primary cancer reported in literature recently

Ref.	Age/sex	Tumors reported
Shibata et al[3]	60/M	Carcinoma of the esophagus/myocardial metastasis
Jena and Nundy[4]	77/M	Esophagus/rectosigmoid/central nervous system
Chen et al[5]	51/M	Pelvis/bladder/colon
Zhang et al[6]	49/W	Colorectal carcinoma/endometrial carcinoma
Liu et al[7]	65/M	Rectal cancer/pelvic classical hodgkin lymphoma
Kang et al[8]	65/M	Esophagus/rectal metastasis

Table 2 History of development of diagnostic criteria for multiple primary cancer

Time	People/organisations	Events
1889	Austrian doctor Christian Billroth	Reported the world's first case of MPC
1932	Warren[14]	First definition of diagnostic criteria for MPC
2004	International Agency for Research in Oncology/International Association of Cancer Registries	Publication of IARC/IACR standards
2007	United States National Research Institute	Presentation of SEER criteria

MPC: Multiple primary cancer.

Table 3 Clinical information

Case	Age	Sex	PH	TFH	Multiple primary cancer				SC or MC	Treatment	Outcome
					Symptoms	Location	Pathology	Staging
1	72	Man	Smoking > 40 years; No alcohol	+	Abdominal pain; Bloating; Nausea	Colon; Hypopharynx	As-ca; Sc-ca	ⅡB; 0	MC	Ope	Died
2	69	Man	Smoking > 20 years; Alcohol > 20years; Long-term oral aspirin	-	Abdominal pain; Weight loss; Back pain; Dizziness; Anaemia; Fatigue	Gastric body; Esophagus; Colon	As-ca; Sc-ca; As-ca	ⅠA; ⅠB; ⅡB	SC	Ope (da Vinci); Chemo (XELOX)	Alive
3	52	Woman	No smoking; No alcohol; diabetes; BMI 32.2	-	Abdominal pain; Bloating; Nausea; Weight loss; Hoarseness; Dysphagia; Anorexia	Gastric body; Esophagus	As-ca; Sc-ca	IIIB; ⅠB	SC	Ope (da Vinci); Chemo (DOX)	Alive

BMI: Body mass index.

Table 4 Immunohistochemistry and FISH studies

	Case No.
	1	2	3
CD31	-	-	+
D2-40	+	-	-
S-100	+	+	+
cgA	-	-	-
P53	+	-	+
Syn	-	-	-
CD56	+	-	-
CDX-2	+	+	-
MLH1	+	-	+
MSH2	+	+	+
MSH6	+	+	+
PMS2	+/--	-	+
Ki-67	75%	70%	80%
Her-2	1+	-	-
Her-2 FISH	-	-	-